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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. BV is recognised from your symptoms and treated by video; a swab is arranged when the picture is unclear, and pain low in the tummy with a fever needs in-person care.
- What it is: an imbalance of the bacteria that normally live in the vagina. It is the most common cause of unusual vaginal discharge, and it is not classed as an STI.
- Main sign: thin, watery, grey-white discharge with a strong fishy smell, often worse after sex. About half of women with BV have no symptoms.
- It often comes back: 50 to 80% of women have BV again within a year of finishing antibiotics, so a plan for repeat episodes matters.
- Emergency: call 112 for severe pain low in the tummy with a high temperature, heavy vaginal bleeding, or collapse.
Do not book a video appointment if you have severe pain low in your tummy with a high temperature, heavy vaginal bleeding, or you feel faint or collapse. Call 112 or go to an emergency department. Pain low in the tummy with a fever, or unusual discharge in pregnancy, needs a prompt examination in person.
Can an online doctor treat bacterial vaginosis?
Yes. BV is usually recognised from the discharge, the smell and how the symptoms started, and a doctor can assess it by video, check whether thrush or an STI fits better, and prescribe antibiotic tablets, a vaginal gel or a cream when they are right for you. You choose what you describe. A first episode with an unclear picture, a possible STI, symptoms in pregnancy, and pain low in the tummy with a fever need a swab, tests or an examination in person, and the doctor tells you where to go.
How an online consultation helps with BV
- BV, thrush or an STI?: The discharge, the smell and any itching point to the cause, and the doctor tells you when a swab is needed to be sure.
- The right antibiotic for you: Tablets, a vaginal gel or a cream, chosen around pregnancy, breastfeeding, your other medicines and what has worked before.
- Clear advice on alcohol and sex: What to avoid during treatment, and when a partner may need treatment too.
- A plan if it keeps coming back: Longer treatment, the triggers worth changing, and when tests for other causes make sense.
What the doctor checks in an online BV consultation
The doctor asks about the warning signs first, then about the discharge itself. The doctor asks about:
- Warning signs: pain low in your tummy, a high temperature, bleeding between periods or after sex, or a chance of pregnancy.
- The discharge: its colour, thickness and smell, and whether it changes after sex or after your period.
- Itching and soreness: these are more typical of thrush or trichomoniasis than of BV.
- STI risk: a new partner or more than one partner, a partner with symptoms, and when you were last tested.
- Your history: earlier episodes, what treated them, and how soon they came back.
- Your health: pregnancy or breastfeeding, a coil (IUD), allergies, and the medicines you take.
Before the call, note when the symptoms started and which washes, soaps or other products you use around the vagina. If the picture is not clear, the doctor tells you which swab or test you need and where to get it, then reviews the result with you.
What is bacterial vaginosis, and what causes it?
BV is an imbalance of the bacteria in the vagina. Normally, lactobacilli keep the vagina slightly acidic; in BV they are outnumbered by other bacteria, and the vagina becomes less acidic. It is the most common cause of unusual vaginal discharge worldwide. The exact cause is not fully known, but these make it more likely:
- being sexually active, although women who have never had sex can get it too
- a new partner, or more than one partner
- a coil (intrauterine device, IUD)
- perfumed soaps, bubble bath, vaginal deodorants and washes, and douching
- smoking
Is BV an STI?
No. BV is not classed as a sexually transmitted infection, but sex can trigger it or pass it on, and condoms lower the risk. BV also makes it easier to catch an STI, including HIV, possibly because the vagina is less acidic and its natural defences are weaker. That is one reason the doctor asks about STI risk, and why testing is worthwhile after a new partner.
Can men get BV?
BV is an imbalance of the bacteria in the vagina, so men do not get it. Current guidelines do not recommend routinely treating male partners. A female partner may need treatment too, so it is worth mentioning if you have sex with women.
What are the symptoms of BV?
The typical sign is a change in discharge with a strong, fishy smell, often noticed after sex. About half of women with BV have no symptoms at all. When it does cause symptoms, they are:
- discharge that becomes thin and watery
- discharge that turns grey or off-white
- a strong fishy smell, especially after sex
BV does not usually cause itching or soreness. Itching points more to thrush, and soreness, pain when you pee or a frothy, yellow-green discharge point to trichomoniasis or another STI.
Swipe sideways to compare →
| Condition | The discharge | Smell | Itching or soreness | Usual treatment |
|---|---|---|---|---|
| Bacterial vaginosis | Thin, watery, grey-white | Strong and fishy, often after sex | Usually none | Antibiotic tablets, gel or cream |
| Thrush | White, often like cottage cheese | Does not usually smell | Itching and irritation around the vulva and vagina | Antifungal cream, pessary or capsule |
| Trichomoniasis | Yellow-green, may be frothy | May smell like fish | Itching, soreness, pain when peeing or during sex | Antibiotics after a test, for you and your partners |
| Normal discharge | Clear or white, changing through your cycle | No unusual smell | None | None needed |
Because these overlap, the smell and colour alone cannot give a certain diagnosis. The vaginal discharge page covers the other causes.
Can BV cause stomach pain?
BV does not usually cause pain. Pain low in the tummy, especially with a high temperature, pain during sex or bleeding between periods, can mean pelvic inflammatory disease, an infection of the womb and fallopian tubes that BV can sometimes lead to. That needs a prompt examination in person.
How is BV diagnosed?
In a clinic, BV is confirmed with a swab of the discharge, which can test for other infections at the same time. Doctors look for at least 3 of 4 signs, known as the Amsel criteria:
- a thin, milky, even discharge
- a vaginal pH above 4.5, meaning the vagina is less acidic than usual
- a fishy smell when a test solution is added to the discharge
- ‘clue cells’, cells from the vaginal lining coated with bacteria, under the microscope
By video, the doctor recognises the usual pattern from what you describe. A swab is the safer next step when it is a first episode and the picture is unclear, when treatment has not worked, when an STI is possible, and in pregnancy. Sexual health clinics often offer walk-in appointments and usually return results faster than a family doctor’s surgery.
How do you get rid of BV?
BV that causes symptoms is treated with antibiotics: tablets by mouth, or a gel or cream used in the vagina. The usual choices work about as well as each other for clearing an episode:
Swipe sideways to compare →
| Treatment | How it is used | Good to know |
|---|---|---|
| Metronidazole tablets | A 7-day course by mouth | No alcohol during the course and for 2 days after it |
| Metronidazole gel | Used in the vagina for 5 days | An option if tablets do not suit you |
| Clindamycin cream | Used in the vagina for 7 days | Vaginal antibiotic creams can bring on thrush |
| Non-antibiotic gels from a pharmacy | Used in the vagina | Ask a pharmacist; see a doctor if the symptoms do not settle or keep returning |
Finish the whole course, even if the smell goes after a few days. Sexual partners do not usually need treatment, apart from a female partner, who may.
Can you cure BV in one day?
There is no reliable one-day cure. The recommended courses last 5 to 7 days. Single-dose tablets exist, but guidelines list them as alternatives rather than first choices.
Treating BV at home: what helps and what does not
No natural remedy is recommended for BV: yoghurt, tea tree oil, garlic and vinegar are not proven, and anything put inside the vagina can irritate it. There is not enough evidence to recommend the probiotics sold in shops. Douching does not clear BV and can make it worse. What does help is washing the outside with water and a plain soap, and avoiding the products that upset the balance.
Why does BV keep coming back?
BV often comes back: 50 to 80% of women have it again within a year of finishing antibiotics, usually within a few months. Doctors usually call BV recurrent after 3 or more episodes in a year.
Breaking the cycle usually takes a combination of steps:
- Treat the episode properly: the same treatment again is reasonable after a first recurrence, or a different one if it did not work.
- Longer treatment: if BV comes back more than 4 times a year, the doctor may suggest an antibiotic gel used in the vagina regularly for a few months. It reduces repeat episodes while you use it, though the benefit can fade after stopping.
- Change the triggers: stop perfumed products, vaginal washes and douching, and stop smoking if you smoke.
- Condoms: they lower the risk of BV, as well as of STIs.
- Contraception: if you have a coil and BV keeps returning, it is worth discussing another method.
- Check the diagnosis: a swab confirms that it is BV and not trichomoniasis or another infection that needs different treatment.
Which BV treatment might the doctor recommend?
Treatment depends on how sure the diagnosis is, how often BV has come back, and whether you could be pregnant. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Typical BV symptoms, not pregnant | Antibiotic tablets, gel or cream | Yes | If the symptoms do not settle after treatment |
| BV that has come back once | The same treatment again, or a different one | Yes | Not usually needed |
| BV more than 4 times a year | Longer treatment with a vaginal gel, and a review of triggers | Yes | For a swab to confirm BV and rule out other infections |
| Unusual discharge after a new partner, or a partner with an STI | STI tests first | Partly | For tests at a clinic or with a home kit |
| Itching, soreness or a frothy, yellow-green discharge | A swab or test for thrush or trichomoniasis | Partly | If a swab is needed to be sure |
| Unusual discharge in pregnancy | Prompt assessment and a swab | No | Promptly, and tell your midwife |
| Discharge with pain low in the tummy and a fever | Examination for pelvic inflammatory disease | No | Promptly; call 112 if the pain is severe |
A fishy smell or unusual discharge? A doctor can tell you in one consultation whether it is BV and what will clear it.
See available times →Treatment options for bacterial vaginosis
What you can do yourself
- Wash the area around the vagina with water and a plain soap, and shower rather than bathe.
- Avoid perfumed soaps, bubble bath and shower gel in the bath, vaginal deodorants and washes, and douches.
- Do not put antiseptic liquids in the bath, and wash underwear in a mild detergent.
- Use condoms with new partners.
- Stop smoking if you smoke.
- Do not put home remedies inside the vagina.
Prescription treatment
A prescription is never issued without a consultation. When BV is the likely cause, the doctor may prescribe metronidazole tablets, a metronidazole gel or a clindamycin cream, chosen around pregnancy, breastfeeding, allergies and what has worked before. For BV that keeps coming back, the doctor may suggest a longer plan with a vaginal gel, and a swab to confirm the diagnosis. Do not drink alcohol while taking metronidazole and for 2 days afterwards. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Douching or washing inside the vagina, which upsets the balance further. Repeating thrush treatment for discharge that smells fishy. Yoghurt, tea tree oil, garlic or vinegar. Stopping antibiotics early because the smell has gone.
Special situations
Pregnancy and breastfeeding
BV in pregnancy carries a small chance of complications such as premature birth or miscarriage, though most pregnancies are not affected. If your discharge changes in pregnancy, tell your midwife or doctor promptly: a swab is usually needed, and the treatment is chosen to be safe in pregnancy. Mention breastfeeding too, because it can change the choice.
A coil (IUD)
A coil is linked to a higher chance of BV. If BV keeps coming back, it is worth discussing whether another method of contraception would suit you; the contraception pages compare the options.
Women who have sex with women
Sex can pass BV between female partners, so a partner with symptoms may need treatment as well. Mention it in the consultation, so the plan covers you both.
BV while travelling in Europe
New products and new partners on holiday can both bring on BV. If you have had it before, tell the doctor what it was like and what treated it. A doctor by video can assess you wherever you are staying, and if you are prescribed metronidazole, remember the no-alcohol rule during the course and for 2 days after.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When BV is treated online, and when you need in-person care
Treated online: typical BV symptoms in someone who is not pregnant, BV that has come back, plans for repeat episodes, and advice on triggers, alcohol, sex and partners.
In-person care: swabs when the cause is unclear, STI tests, unusual discharge in pregnancy, discharge with pain low in the tummy or a fever, bleeding between periods or after sex, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- severe pain low in the tummy with a high temperature
- heavy vaginal bleeding
- fainting or collapse
Get medical advice the same day for:
- pain low in the tummy, or pain during sex, with unusual discharge
- unusual discharge with a high temperature or feeling unwell
- unusual discharge in pregnancy
- bleeding between periods or after sex
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: describe the discharge and any smell or itching, say when it started, and mention earlier episodes, pregnancy and any new partner.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s BV? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Thrush can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about bacterial vaginosis
What is BV?
Bacterial vaginosis is an imbalance of the bacteria in the vagina, where the protective lactobacilli are outnumbered by other bacteria. It is the most common cause of unusual vaginal discharge, and it is not classed as an STI.
What causes BV?
The exact cause of BV is not known. Being sexually active, a new partner, a coil, perfumed products, vaginal washes, douching and smoking all make it more likely, but women who have never had sex can get it too.
Is BV an STI?
No. BV is not classed as a sexually transmitted infection, but sex can trigger it or pass it on. Having BV makes it easier to catch an STI, including HIV, so testing is worthwhile after a new partner.
Is it BV, thrush or an STI?
BV is thin, watery, grey-white discharge with a fishy smell and little itch or soreness. Thrush is thick, white, cottage-cheese discharge with intense itching and soreness and no smell; trichomoniasis is frothy yellow-green discharge with soreness and sometimes a fishy smell, which is why a swab matters; chlamydia and gonorrhoea often cause no discharge at all but can bring bleeding after sex or pain passing urine. A new partner, pain or bleeding means STI tests alongside BV treatment.
Can men get BV?
No. BV is an imbalance of the bacteria in the vagina. Current guidelines do not recommend routinely treating male partners, but a female partner may need treatment too.
What should I avoid, and what helps, if I have BV?
Avoid perfumed soaps, bubble bath, vaginal deodorants and washes, and douching. Do not drink alcohol while taking metronidazole and for 2 days afterwards. Condoms lower the risk of BV coming back.
Does BV go away on its own?
BV can come and go, and about half of women with BV have no symptoms. When it causes symptoms, antibiotics are the recommended treatment, and BV that keeps returning needs a plan rather than repeated guesswork.
How do you get rid of BV?
BV is treated with antibiotics: metronidazole tablets for 7 days, a metronidazole gel for 5 days, or a clindamycin cream for 7 days are the usual choices. There is no reliable one-day cure, and natural remedies are not recommended.
Can I drink alcohol while being treated for BV?
Not with metronidazole, the usual BV treatment. Avoid alcohol during the course and for 2 days after you finish it. If you use a clindamycin cream instead, ask the doctor or pharmacist what applies to that treatment.
Why does my BV keep coming back?
BV often returns after treatment: 50 to 80% of women have it again within a year, usually within a few months. Longer treatment with a vaginal gel, avoiding triggers, condoms and checking the diagnosis with a swab can break the cycle.
Can BV cause stomach pain?
BV does not usually cause pain. Pain low in the tummy, especially with a fever, pain during sex or bleeding between periods, can mean pelvic inflammatory disease and needs a prompt examination in person.
Is BV dangerous in pregnancy?
With BV in pregnancy there is a small chance of complications such as premature birth or miscarriage, though most pregnancies are not affected. Tell your midwife or doctor promptly if your discharge changes in pregnancy, because a swab and pregnancy-safe treatment are needed.
Can an online doctor treat BV?
Yes, usually. A doctor can recognise BV from your symptoms by video and prescribe antibiotic tablets, a gel or a cream. An unclear picture, a possible STI, pregnancy or pain with a fever needs a swab or an examination in person.
- Bacterial vaginosis, NHS, National Health Service (UK), reviewed 19 June 2026.
- Bacterial vaginosis: sexually transmitted infections treatment guidelines, CDC, US Centers for Disease Control and Prevention, 2021.
- Bacterial vaginosis: a review of approaches to treatment and prevention, Abbe C, Mitchell CM. Frontiers in Reproductive Health, 2023.
- Bacterial vaginosis, NHS inform (Scotland), updated 2 December 2022.
- Common questions about metronidazole, NHS, National Health Service (UK), reviewed 31 December 2025.
- Bacterial vaginosis: symptoms and causes, Mayo Clinic (US), updated 10 June 2023.
- Bacterial vaginosis, Brighton Sexual Health (UK), accessed 15 October 2026.
- Thrush in men and women, NHS, National Health Service (UK), reviewed 28 July 2023.
- Trichomoniasis, NHS, National Health Service (UK), reviewed 16 July 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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